Description
The datasets contain reimbursement rates paid to participating County Organized Health Systems, Geographic Managed Care, Regional, Senior Care Act (SCAN), Single Plan, and Two-Plan model counties as well as Program of All-Inclusive Care for the Elderly (PACE) organizations for calendar years 2021-2025.
Resources
| Name | Format | Description | Link |
|---|---|---|---|
| Data Dictionary - Two-Plan Model | CSV | Data Dictionary for https://data.chhs.ca.gov/dataset/4f2af880-e909-466a-bb2d-9fd010fa0e69/resource/833ddd94-d5ea-4bbc-8980-ba236ab64bf8/download/two-plan-model-2025.csv | Open resource |
| Data Dictionary - Single Plan Model | CSV | Data Dictionary for https://data.chhs.ca.gov/dataset/4f2af880-e909-466a-bb2d-9fd010fa0e69/resource/1d96751e-59c3-4cd2-9c75-32a6e777ba4b/download/single-plan-2025.csv | Open resource |
| Data Dictionary - Senior Care Action Network (SCAN) | CSV | Data Dictionary for https://data.chhs.ca.gov/dataset/4f2af880-e909-466a-bb2d-9fd010fa0e69/resource/e9e46e92-b9cd-4cef-bd0f-13448e3e6a9a/download/senior-care-action-network-scan-2025.csv | Open resource |
| Data Dictionary - Geographic Managed Care (GMC) | CSV | Data Dictionary for https://data.chhs.ca.gov/dataset/4f2af880-e909-466a-bb2d-9fd010fa0e69/resource/7d140e72-4dc6-4c5f-88b2-22e96a9876e1/download/geographic-managed-care-gmc-2025.csv | Open resource |
| Data Dictionary - Program of All-Inclusive Care for the Elderly (PACE) Rates | CSV | Data Dictionary for https://data.chhs.ca.gov/dataset/4f2af880-e909-466a-bb2d-9fd010fa0e69/resource/e2af0f7c-2b53-46a5-8bf0-601e2e51f3d1/download/program-of-all-inclusive-care-for-the-elderly-pace-rates_2021-2025.csv | Open resource |
| Data Dictionary - Regional Model/Rural Expansion | CSV | Data Dictionary for https://data.chhs.ca.gov/dataset/4f2af880-e909-466a-bb2d-9fd010fa0e69/resource/d55907d0-ffbe-4817-9d08-74ff2c85e74a/download/regional-model-2025.csv | Open resource |
| Data Dictionary - County Organized Health Systems (COHS) Model | CSV | Data Dictionary for https://data.chhs.ca.gov/dataset/4f2af880-e909-466a-bb2d-9fd010fa0e69/resource/b053161a-8155-43e5-98ab-11274ecd9cda/download/county-organized-health-systems-cohs-model-2025.csv | Open resource |
| Starting CY 2022 | Markdown | This is not actual data resource. Please refer to CSV resource. This is a markdown file. | Open resource |
| Single Plan Model | CSV | Medi-Cal Managed Care Capitation Rates for the single plan models for Calendar Year 2024. DHCS contracts with an MCP that operates under the authorization and sponsorship of a county or local authority. __See Calendar Year tabs for changes throughout the years.__ | Open resource |
| Starting CY 2021 | Markdown | This is not actual data resource. Please refer to CSV resource. This is a markdown file. | Open resource |
| Starting CY 2025 | Markdown | This is not actual data resource. Please refer to CSV resource. This is a markdown file. | Open resource |
| Geographic Managed Care (GMC) | CSV | Medi-Cal Managed Care Capitation Rates – Geographic Managed Care (GMC) for Calendar Years 2021-2024. Medi- Cal managed care health plans in the Sacramento and San Diego counties. __See Calendar Year tabs for changes throughout the years.__ __For archived data, please refer to the historical landing page at [Medi-Cal Managed Care Capitation Rates - Geographic Managed Care (GMC)](https://data.chhs.ca.gov/dataset/medi-cal-managed-care-capitation-rates-geographic-managed-care-gmc)__ | Open resource |
| Two-Plan Model | CSV | This dataset displays reimbursement rates paid to Medi-Cal Managed Care health plans in Two-Plan model counties from 2021-2024 Calendar Year. In Two-Plan model counties, the Department of Health Care Services (DHCS) contracts with a local initiative (county organized) and a commercial plan. __See Calendar Year tabs for changes throughout the years.__ __For archived data, please refer to the historical landing page at [Medi-Cal Managed Care Capitation Rates – Two-Plan Model](https://data.chhs.ca.gov/dataset/medi-cal-managed-care-capitation-rates-two-plan-model)__ | Open resource |
| County Organized Health Systems (COHS) Model | CSV | This dataset displays reimbursement rates paid to Medi-Cal Managed Care health plans in the COHS model for Calendar Years 2021-2025. The COHS serves beneficiaries in 22 counties. In the COHS model counties, the Department of Health Care Services (DHCS) contracts with a health plan created by the county Board of Supervisors. In a COHS county, all Medi-Cal members are enrolled in the same managed care health plan. __See Calendar Year (CY) tabs for changes throughout the years.__ __For archived data, please refer to the historical landing page at [Medi-Cal Managed Care Capitation Rates – County Organized Health Systems (COHS) Model](https://data.chhs.ca.gov/dataset/medi-cal-managed-care-capitation-rates-county-organized-health-systems-cohs-model)__ | Open resource |
| Starting CY 2024 | Markdown | This is not actual data resource. Please refer to CSV resource. This is a markdown file. | Open resource |
| Regional Model/Rural Expansion | CSV | This dataset displays reimbursement rates paid to Medi-Cal Managed Care health plans in the Regional model, for Calendar Years 2021-2024. The Regional Model serves beneficiaries in 28 rural counties: Alpine, Amador, Butte, Calaveras, Colusa, Del Norte, El Dorado, Glenn, Humboldt, Inyo, Imperial, Lake, Lassen, Mariposa, Mendocino, Modoc, Mono, Nevada, Placer, Plumas, San Benito, Sierra, Siskiyou, Sutter, Tehama, Trinity, Tuolumne, and Yuba. The Department of Health Care Services (DHCS) contracts with two Commercial plans to provide services in each county. San Benito is the only exception where beneficiaries can choose either the managed care plan or (fee-for-service) Medi-Cal. __See Calendar Year tabs for changes throughout the years.__ __For archived data, please refer to the historical landing page at [Medi-Cal Managed Care Capitation Rates – Regional Model/Rural Expansion](https://data.chhs.ca.gov/dataset/medi-cal-managed-care-capitation-rates-regional-model-rural-expansion)__ | Open resource |
| Program of All-Inclusive Care for the Elderly (PACE) Rates | CSV | The dataset contains reimbursement rates paid to participating Program of All-Inclusive Care for the Elderly (PACE) organizations for calendar years 2021-2024. To be eligible for the PACE program, a person must be 55 years of age or older and reside in one of the following PACE service areas: Alameda, Contra Costa, Fresno, Humboldt, Los Angeles, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, Santa Clara, Stanislaus. __See Calendar Year tabs for changes throughout the years.__ __For archived data, please refer to the historical landing page at [Program of All-Inclusive Care for the Elderly (PACE) Rates](https://data.chhs.ca.gov/dataset/program-of-all-inclusive-care-for-the-elderly-pace-rates)__ | Open resource |
| Senior Care Action Network (SCAN) | CSV | Medi-Cal Managed Care Capitation Rates for Capitated Rates for Senior Care Action Network (SCAN) – for Calendar Year (CY) 2021-2025. Senior Care Action Network (SCAN) Health Plan is a Medicare Advantage Special Needs Plan that contracts with the Department of Health Care Services for dual eligible Medicare/Medi-Cal population subset residing in Los Angeles, San Bernardino, and Riverside counties. __See Calendar Year tabs for changes throughout the years.__ __For archived data, please refer to the historical landing page at [Medi-Cal Managed Care Capitation Rates - Senior Care Action Network (SCAN)](https://data.chhs.ca.gov/dataset/medi-cal-managed-care-capitation-rates-senior-care-action-network-scan)__ | Open resource |
| All resource data | ZIP | medi-cal-managed-care-capitation-rates-by-managed-care-plan-models-consolidated-smqmhpel.zip | Open resource |
| Starting CY 2023 | Markdown | This is not actual data resource. Please refer to CSV resource. This is a markdown file. | Open resource |